"New" style CPR

[ccmedoc]

Any thoughts on this research??

Purdue did some research on abdominal thrust CPR in comparison to chest compression---

http://www.sciencedaily.com/releases/2007/...70905155141.htm

[emtannie]

Very interesting article… especially a couple of points made.

“Another problem is the risk of transferring infection with mouth-to-mouth breathing."

“However, the risk of infection is so grave that many doctors and nurses often refuse to administer mouth-to-mouth resuscitation. In one 1993 study of 433 doctors and 152 nurses, 45 percent of doctors and 80 percent of nurses said they would refuse to administer mouth-to-mouth resuscitation on a stranger.”

A 1997 AHA article (Circulation. 1997;96:2102-2112) states that the actual risks of disease transmission during mouth-to-mouth ventilation are quite small. There are isolated reports of possible transmission of Helibacter pylori, Mycobacterium tuberculosis, meningococcus, herpes simplex, shigella, streptococcus, and salmonella. No reports on transmission of HIV can be found. Nevertheless, despite the remote chances of its occurring, fears regarding disease transmission are common in the current era of universal precautions.”

An article written by Dr. Carlos Frederico Arend in 2000 for the Brazil Cardiology Association states “Since the first medical use of mouth-to-mouth ventilation in 1744, only the transmission of tuberculosis, Neisseria meningitidis, Herpes simplex, Helicobacter pylori, Shigella sonnei and Salmonella infantis have been documented. No case of hepatitis or HIV transmission has been described over these 254 years.. “

One only has to Google “disease transmission mouth to mouth” to get pages of reference materials indicating that the actual risks are quite small; however, the emotional fear of the transmission is the bigger factor in people refusing to provide mouth-to-mouth resuscitation. The touching of one’s mouth to someone else’s is a very personal and private touch, which most people are not prepared to do to a stranger. I think this is more the issue than the actual disease transmission.

“Whether the procedure gains widespread acceptance depends on whether other researchers can duplicate the results.”

It will be very interesting to see if the results can be duplicated. If continued research shows that this method is more effective and has better surviveabilty results, we should be open to the change. I suspect ILCOR will be watching these studies very closely, and that we will again see changes to CPR protocols in the next 5 years.

[Just Plain Ruff]

An article written by Dr. Carlos Frederico Arend in 2000 for the Brazil Cardiology Association states “Since the first medical use of mouth-to-mouth ventilation in 1744, only the transmission of tuberculosis, Neisseria meningitidis, Herpes simplex, Helicobacter pylori, Shigella sonnei and Salmonella infantis have been documented. No case of hepatitis or HIV transmission has been described over these 254 years

so HIV has been around for 254years?

plus, why are they using data from 1993 and 2000? Isn't there any more recent studies to use?

[emtannie]

The original article uses a 1993 statistic...

Upon review of the "Circulation" archives, and JAMA as well, most recent articles still refer back to the studies of the late 1990's. I will keep searching though, to find you more recent stats.

I also suspect part of the sentence "No case of hepatitis or HIV transmission has been described over these 254 years" was altered in the translation from Portugese to English, making it sound like HIV has been around for 254 years, when that probably was not the original author's intent.

[DwayneEMTP]

I watched the video on this when this topic came up before...Some said it was done away with 20+ years ago...

The first thing that pops into my head is...We stopped doing the Heimlick on drowning victims to expel water based partially on the fact that it encouraged the victims to vomit and aspirate...

And many experienced medics tell me arrests often happen immediately following a large meal (urban legend?), wouldn't it seem that this technique would be contraindicated in many arrests?

Just thinkin'....

Dwayne

[mrmeaner]

Judging by the related articles listed below the story, every conceivable meathod of CPR is being studied. None seem to have a whole lot of merit to me though.

[Riblett]

It seems that these abdominal compressions would cause extensive risks of vomiting and subsequent aspiration. It might be beneficial to restrict this compressions to post intubation resuscitation efforts.

I think that, despite the obvious benefits to the patients, long time providers and even less liberal medical directors would be resistant to implementing the change. Not to mention the five to ten years of research and meandering it would take for AHA to change the guidelines.

[BEorP]

Any thoughts on this research??

Purdue did some research on abdominal thrust CPR in comparison to chest compression---

http://www.sciencedaily.com/releases/2007/...70905155141.htm

Since they are able to say this...

... it increases nourishing blood flow through the heart by 25 percent over the current method.

I'm going to guess that this is based on a pig study... Pigs and humans are very different but it will be interesting to see if they trial it in the field or hospital at all.

[unknown]

I am glad to see I wasn't the only one worried about the whole vomiting and asperation thing too....

[BEorP]

Judging by the related articles listed below the story, every conceivable meathod of CPR is being studied. None seem to have a whole lot of merit to me though.

What is it about the current CPR that gives it so much merit over any of the new ideas or ideas for improved methods?